Comparison of hysterosalpingography and laparoscopy in infertile Iranian women with tubal factor

Mechanical factors are responsible for approximately 30% of female infertility and various methods such as transvaginal ultrasonography, hysterosalpingography (HSG), hysteroscopy and laparoscopy have been used to investigate these factors. The aim of this study was to evaluate if HSG alone can be accurately used, compared with laparoscopy in order to reduce health care costs in high medical standard setting in infertile women with tubal factor

Retrospectively medical records of women admitted to a local Iranian hospital were selected. Records of those who underwent both HSG and laparoscopy were studied. Afterwards, the findings were compared in regard to tubal obstruction.

A total number of 181 records was included into the study By both methods, 99 women were evaluated to have normal findings, and 37 women - abnormal findings, i.e. 136 of 181 (75%) HSG reports were accurate in reference to laparoscopy However there were 3 patients with abnormal fallopian tubes that were not detected by HSG and, moreover; 42 patients with normal tubes which were reported as abnormal by HSG. The calculated sensitivity and specificity of HSG in our study were 0.92 and 0.70, respectively

Although laparoscopy is considered as the reference standard in infertility workup, HSG can be performed first and, therefore, the use of laparoscopy should be limited to cases suspected for etiologies other than intratubal, such as endometriosis and peritubal adhesions.